What is the expected scope of urology in the next 10 years?

The Future Scope of Urology in the Next 10 Years

The scope of urology in the next decade will be primarily shaped by advances in minimally invasive surgery, telemedicine, and a significant increase in workload from deferred elective procedures, with prostate biopsies and surgeries for benign conditions representing the most substantial burden. 1

Key Areas of Growth and Evolution

Surgical Workload and Prioritization

• The most significant impact on urologists' workload will come from prostate biopsies and elective procedures for benign conditions in the outpatient setting 1
• In the inpatient setting, elective surgeries for lower-risk prostate and renal cancers, nonobstructing stone disease, and benign prostatic hyperplasia (BPH) will constitute the majority of the surgical burden 1
• Kidney transplantation from deceased donors will continue to pose challenges for urologists due to higher risks for recipients and complex logistics, though this may not significantly impact overall workload due to centralization at specialized centers 1

Technological Advancements in Robotic Surgery

• Robotic surgical systems will continue to evolve with next-generation platforms featuring modular designs, open access consoles, haptic feedback, smaller instruments, and machine learning capabilities 2
• The robotic surgery market, currently dominated by the Da Vinci Surgical System, will likely transform within the next decade as new competitors enter the field 2, 3
• Pediatric urology will benefit from continued development of smaller 5mm instruments and pediatric-friendly components, addressing current limitations in minimally invasive surgery for children 3

Minimally Invasive Surgery (MIS)

• MIS will remain the preferred approach for many urological procedures, with continued refinement of techniques to improve safety and outcomes 1
• Precautionary measures during MIS will evolve, including advanced smoke evacuation systems, improved CO2 insufflation with closed systems, and better filtering of aerosolized particles 1
• The use of intelligent integrated insufflation systems during laparoscopic and robotic procedures will become standard practice 1

Telemedicine Integration

• Telemedicine will play an increasingly important role in urology practice across various contexts, including initial clinical assessments, multidisciplinary tumor boards, and follow-up visits 1
• The integration of telehealth will help reorganize diagnostic and therapeutic pathways of care, though its ultimate impact on urology practice requires further investigation 1
• Patient acceptance of telemedical appointments will likely increase, as demonstrated during the COVID-19 pandemic 1

Subspecialty Developments

Oncology

• Management of small renal masses will shift toward alternative treatment strategies, including active surveillance and ablative therapies, potentially reducing the surgical burden 1
• Cystoscopy and intravesical instillations will remain priority procedures for patients with higher-risk non-muscle-invasive bladder cancer 1
• Prostate cancer management will continue to evolve with potential shifts to alternative treatment strategies beyond radical prostatectomy 1

Stone Disease

• There will be a substantial increase in procedures for stone disease due to the accumulation of deferred cases 1
• Innovations in stone management technologies will be necessary to address the growing burden of stone disease 1
• Timely rescheduling of elective stone surgeries will be crucial to prevent complications such as chronic renal failure 1

Functional Urology and Andrology

• Surgical procedures for functional/reconstructive conditions, urogynecological issues, and andrological diseases will face significant backlogs 1
• The delay in treating these conditions may lead to progressive worsening of patients' quality of life and underlying diseases 1
• Increased risks of recurrent/complicated urinary tract infections and antibiotic resistance may occur, especially in patients with indwelling catheters 1

Challenges and Opportunities

• The management of surgical waiting lists will be a major challenge, particularly for elective procedures that were deferred 1
• Clinical conditions of patients on waiting lists may worsen, potentially becoming medical emergencies with medicolegal implications 1
• The development of new technologies and techniques will be essential to address the increasing workload efficiently 4, 2
• Continued evolution of urological practice will require adaptation of training programs for future urologists 5, 6